[Ip-health] Lancet: Health Impact Fund viewpoint

[Matt Peterson]

The Lancet, Volume 375, Issue 9709, Pages 166 - 169, 9 January 2010

The Health Impact Fund: incentives for improving access to medicines
Amitava Banerjee, Aidan Hollis, Thomas Pogge

"Key features of the Health Impact Fund
+ A global agency, funded by governments
+ Features yearly reward pools from which a new medicine can, for 10 years,=
 receive a share that corresponds to that drug's contribution to the global=
 health effect of all HIF-registered drugs
+ Optional registration requires the innovator to offer the product at the =
lowest feasible cost of production and distribution and to provide zero-cos=
t licences at the end of the reward period
+ Has benefits for patients, taxpayers, and pharmaceutical companies"

...

"The global health impact assessment will draw on the same types of informa=
tion that agencies such as the National Institute for Health and Clinical E=
xcellence (NICE) now use to make recommendations about listing new drugs, b=
ut will continually update this information with data for use of the drug a=
nd information from new practical trials. No method of global health impact=
 assessment could be perfect and indisputable in its measurements or the es=
timates produced from it. However, although these drawbacks are serious, th=
e real comparison is not with a perfect system but with the present situati=
on. In the UK, where drug insurance is universal and NICE assesses the cost=
-effectiveness of medicines, the present situation might be seen as a rewar=
d system in which each sale of a drug creates a reward equal to the differe=
nce between the price and the cost of manufacture and distribution. The siz=
e of the reward per pill is fixed on the basis of information provided to N=
ICE at the time of drug approval, and is typically not modified to show new=
 information. Thus, the UK system is essentially a simple reward system in =
which the reward equals the price=97cost margin multiplied by the number of=
 units sold.

HIF's global health impact assessment would improve on this standard in at =
least five important ways...

An objection that this information is inadequate to form the basis for rewa=
rds is implicitly an argument in favour of HIF, because the proposed scheme=
 uses much more information than does the present reward system. Just becau=
se global health impact assessments will not have enough information to est=
ablish rewards perfectly cannot be an argument for use of even less relevan=
t information."

--
Matt Peterson
CFO, Incentives for Global Health
www.healthimpactfund.org